A Modified Suture Technique to Improve Scar Appearance in Wounds Under High Tension

被引：3

作者：

Liu, Hui ^{[1
,2
,3
]}

Lin, Mao-Hui ^{[1
,2
,3
]}

Jiang, Ling-Li ^{[1
,2
]}

Chang, Shu-Sen ^{[1
,2
]}

Chen, Wei ^{[1
,2
]}

Nie, Kai-Yu ^{[1
,2
]}

Huang, Guang-Tao ^{[1
,2
]}

Qi, Fang ^{[1
,2
]}

Zhou, Xiao-Fan ^{[3
]}

Chen, Jian-Da ^{[3
]}

Deng, Cheng-Liang ^{[1
,2
,4
]}

Wei, Zai-Rong ^{[1
,2
,4
]}

机构：

[1] Zunyi Med Univ, Affiliated Hosp, Dept Burns & Plast Surg, Zunyi, Peoples R China

[2] Zunyi Med Univ, Collaborat Innovat Ctr Tissue Damage Repair & Rege, Zunyi, Peoples R China

[3] Third Peoples Hosp Guizhou, Dept Plast Surg, Guiyang, Guizhou, Peoples R China

[4] Zunyi Med Univ, Affiliated Hosp, Dept Plast Surg, 149 Dalian Rd, Zunyi 563000, Guizhou, Peoples R China

来源：

ANNALS OF PLASTIC SURGERY | 2023年 / 91卷 / 06期

关键词：

tension; scar; simple interrupted suturing method; vertical mattress suture; dermis; myofibroblast expression; TGF beta 1 expression; HORIZONTAL MATTRESS SUTURE; MYOFIBROBLASTS; TRANSDIFFERENTIATION; TGF-BETA-1; ANTIBODY;

D O I：

10.1097/SAP.0000000000003693

中图分类号：

R61 [外科手术学];

学科分类号：

摘要：

The purpose of this study was to introduce a modified suture technique and to compare its effects on skin scar formation with 2 traditional suture methods: simple interrupted suture (SIS) and vertical mattress suture (VMS). Three groups of healthy adult female Sprague-Dawley rats were selected (6 replicates in each group), and the full-thickness skin of 5 cm x 0.2 cm was cut off on the back of the rats after anesthesia. The wounds were then sutured using 1 of the 3 methods for each group: SIS, VMS, and a newly introduced modified vertical mattress suture (M-VMS) technique with the needle reinsertion at the exit point. A traction device was installed on the back of the rats to achieve high tension wounds. The tensile distance was increased by 1 mm every day for 20 days. After 20 days of healing, the hematoxylin-eosin staining method was used for observation of scar morphology. The collagen production rate was measured by Masson staining, and the type I collagen and type III collagen were detected by the immunofluorescence method. Immunohistochemical staining was used to detect the expression of myofibroblast marker alpha-smooth muscle actin, and real-time quantitative polymerase chain reaction and Western blot techniques were used to detect the expressions of transforming growth factors TGF beta 1, TGF beta 2, and TGF beta 3 to understand the mechanisms of scar formation. Results showed that the quantity and density of collagen fibers were both lower in the M-VMS group than in the other 2 groups. Immunofluorescence results showed that type I collagen was significantly lower, whereas type III collagen was significantly higher in the M-VMS group than in the other 2 groups. The expressions of alpha-smooth muscle actin and TGF beta 1 both were lower in the M-VMS group than in the other 2 groups. The expression of TGF beta 2 and TGF beta 3 had no obvious difference among the 3 groups. For wounds under high tension, compared with SIS and VMS methods, the M-VMS technique we proposed can reduce scar formation due to the reduction of collagen formation, myofibroblast expression, and TGF beta 1 expression.

引用

页码：763 / 770

页数：8